Ask Dr. Z

Can we charge for spot ablations? Would this be reported with codes 93656 and 93657?

"Wide, extra ostial pulmonary vein antral isolation was performed with power cutoffs of 25 watts when ablating on the posterior wall and 30/35 watts when ablating elsewhere. The right phrenic nerve was marked by high output pacing after reversing the paralytic agent, and ablation was predominantly performed without paralytic agents. There was no evidence of right phrenic nerve paralysis during or after the procedure.

Spot-ablation was performed on the posterior wall of the left atrium between an anterior roofline and an inferior floor line. The patient was then cardioverted to sinus rhythm. After cardioversion, entrance and exit block were demonstrated using differential pacing maneuvers. There was loss of voltage in the left atrium within the ablated area. Partial carinal ablation was required bilaterally. Wide, extra ostial pulmonary vein antral isolation, bilateral carina lesion, LA roof line creation, and RA CTI line ablation."